You're stuck at home. If you're like many people, you've been walking more. Perhaps you've also started working out at home. As a result, you may be wondering if it's OK to work out barefoot or in stocking feet.

The answer is, it depends. If you've been Zooming into a yoga or Pilates class your fine. These forms of exercise are low impact.

But recently patients have been coming in with foot pain as a result of doing higher impact workouts at home while barefoot. Heel pain, Achilles tendonitis, and other foot problems can result when additional pressure is added to the plantar fascia--the thick band of tissue which originates at the heel, travels across the arches, and inserts into the base of the toes.

When you go barefoot your feet don't have the support they need to withstand the higher pressure placed on them.

When doing higher impact activities it's important to wear athletic shoes designed for that exercise. Be sure you're shoes aren't showing signs of wear. Also, shoes should only bend at the toes, not in the middle, be hard to wring out like a rag, and have a firm heel counter. To learn more about buying supportive shoes, view this video on how to test your shoes.

If you're experiencing foot pain call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Nicole Kidman is a trouper. While husband Keith Urban was doing a surprise benefit concert in support of frontline workers in Tennessee she showed up all smiles while donning a walking boot. Turns out she was running around her neighborhood and didn't see a pothole. She rolled her ankle and ended up breaking it.

You might think foot and ankle injuries occur most often in the young and the restless or athletes. But just as often, hanging out at home can be just as hazardous. One of the most common dangers is slamming your toe into a dresser or other hard object in the middle of the night.

But there are many other hazards in the home and backyard which can lead to a broken ankle an other foot injuries. Now that you're home more, scanning your house and yard for tripping dangers will help prevent a broken ankle or worse.

Here are my recommendations:

Don't go barefoot - as much as you might want to kick off your shoes while cleaning up your yard or gardening, don't do it. Lack of foot support can lead to trip, fall, and twisted ankle. It's best to wear tennis shoes or a clog like Oofos (which can also be helpful for people with heel pain) when in the garden.

Check your shoes to wear - turn your tennis shoes over. Do you see any uneven wear? If so, it's time to buy a new pair. Worn out shoes do not provide good support.

Always wear closed toed shoes when mowing your lawn.

Check your yard for stray hoses, fallen tree limbs, and divots.

Remove clutter from your home - now is a great time to clean up the areas of your home that are potential fall hazards. In particular, remove any objects on the floor.

Check area rugs to ensure edges can't come up and that there's non-slip backing.

Coil or tape cords and wires next to the wall. If needed, have an electrician install another outlet.

Install a night light so you can see where you're going in the middle of the night.

What To Do If You Think Your Ankle Is Broken

So you've fallen and your ankle is killing you. Should you go see your podiatrist or doctor? The short answer is yes, if you want to make sure it's not broken. It's almost impossible to tell without an X-ray if your ankle is broken or sprained. The truth is that a sprain can take much longer to heal than a fracture or break.

Whatever you decide to do, it's important to take action right away to keep down the inflammation, swelling and pain you'll experience with either situation. We recommend using the RICE protocol to accomplish this.RICE stands for Rest, Ice, Compression, and Elevation.

Rest - stop all physical activity and don't put any weight on the affected ankle.

Ice - apply an ice pack to the affected area (with a layer of cloth between your skin and the ice), 20 minutes on and 20 minutes off.

Compression - use an elastic or Ace bandage to provide compression to the area.

Elevate - keep the ankle elevated as much as possible.

If the affected ankle isn't healing after a week or so, please make an appointment with our office. In addition to an X-ray, an MRI may be required to assess damage to the underlying soft tissue.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

We are now offering telemedicine in addition to in person appointments.

Despite current concerns about Covid-19, most of us are getting outside. We’re soaking up the sun while gardening or by walking and running in our neighborhoods. Some of us are also frequenting parks and golf courses, now that those are open as of May 1st.

With more physical activity comes foot pain. You may be wondering if you need to come into the office to get your particular foot condition evaluated and treated. The answer is, not necessarily. Through the wonders of telemedicine I can listen to you describe the pain you’re having, you can show me your feet, and I can watch you walk. Oftentimes these will be sufficient for me to prescribe you a home treatment program and/or write you a prescription you can pick up at your pharmacy. Sometimes we will have the item you need at the office. You can pay for these over the phone and then pick them at the door.

So what are some of the most common conditions I’m seeing through telemedicine?

Heel pain

Ingrown toenails

Cracked skin

Broken toes

Heel Pain

Heel pain is usually either plantar fasciitis (bottom of the heel pain) or Achilles tendonitis (back of the heel pain). These conditions are most often brought on by a combination of the following factors: an increase in exercise (walking and running), going barefoot in the house or outside, overpronation (a tendency to pronate or roll your foot inward during movement) and having tight calf muscles.

I’ve helped many patients resolve their heel pain during a telemedicine call by learning more about their particular issues and by watching them walk.

To resolve your heel pain at home, take the following steps:

Wear supportive tennis shoes

Don't go barefoot at home, but instead wear support sandals

Reduce your inflammation

Add over-the-counter inserts

Reduce your calf tightness

Use a heel lift

To learn more about how to resolve your heel pain at home, review the blog I wrote and the companion video, “6 Self-Care Tips to Resolve Heel Pain During the Covid-19 Pandemic”. The blog contains links to all the products I recommend.

Ingrown Toenail

If you’ve ever experienced an ingrown toenail you know how painful it can be. Although in most cases I’ll need to see you in the office to do minor surgery, we may be able to resolve your issue through a telemedicine call.

First I’ll ask you about the state of your toe. Is it painful, red, swollen, or is there any pus or drainage? Your responses to these questions will help me understand whether your ingrown toenail is infected. I’ll also view your toe during our telemedicine call. After my assessment I’ll determine whether you can start home treatment or whether you need to come into the office for surgery.

To care for your ingrown nail at home take the following steps:

Epsom salt soak - soak your toe in a bucket or other container with warm water and ½ cup of Epsom salt for about 15 minutes twice a day.

Apply a wet to dry dressing – wrap your toe with gauze and secure with tape (make sure you don’t tape the gauze to your toe. Saturate the gauze with the Epsom salt soak and let it dry while you wear an open toed shoe. Apply twice daily.

Wear sandals - wear sandals or another open toed shoe to avoid pressure on the nail.

Note: If redness, pain, or drainage increase you’ll need to make an in office appointment.

Cracked Heels

Walking around barefoot indoors and outside will often lead to dry and cracked heels due to increased pressure on that part of the foot. If your cracks are minor you won’t need a telemedicine appointment. However, more severe cracks particularly those that are deep and bleeding will require a telemedicine call.

Recently we’ve been reading about a new phenomenon some people are calling Covid toes. Mostly younger patients with Covid-19 in their 20s and 30s are experiencing a pinkish-red rash that can also turn purple over time. The toes can appear to be frostbitten with skin sores or bumps. This condition can also cause burning in some people. Most people who get this rash are asymptomatic with it disappearing in two to three weeks.

Because patients are asymptomatic the most important thing about this condition is that people who experience it should get tested and isolate themselves from others who could have a much worse case of Covid-19.

If you think you or your child has this condition, I can diagnose it through a telemedicine appointment.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

As we shelter in place, most of us are stuck at home and unable to participate in many of our usual activities. Without gyms or swimming pools to go to for recreation and exercise many more of us are turning to walking. A great thing with all the lovely weather we’ve been having. Unfortunately, a lot people are calling my office because they’ve suddenly developed heel pain.

During our telemedicine appointments I’m finding that there are three main culprits to this Covid-related problem. People are walking much more than usual. When folks are at home they’re going barefoot more often. And finally, many people are wearing flip flops because the weather has been so nice.

Fortunately, there are a lot of things you can do at home to help with a case of heel pain.

Wear Supportive Tennis Shoes

It’s important to wear supportive tennis shoes or a supportive sandal when walking if you’re experiencing heel pain. To get a better understanding of why people are suddenly developing heel pain, let’s look at how the foot works. To work well, the feet need to bend at the ankle and at the ball of the foot, not in half. Shoes need to support the feet in the same way. They should allow you to bend at the ankle and at the ball of the foot, not in the middle. When the shoe is twisted from side to side it should be fairly firm. The heel counter in the back of the shoe should also be firm.

Instead people have been coming in wearing shoes with mesh and squishy soles. Shoes like that bend in half right with little pressure and can easily twist when wrung out like a rag. This type of shoe provides little support. Instead of the shoe propelling you forward you’re going to spend more time on the heel.

People who are experiencing heel pain or are prone to developing it shouldn’t go barefoot at home. And even flip flops won’t provide you with the support you need. Instead try a shoe or sandal that has some degree of stability. I recommend Crocs, Merrills, Tevas, or Keens.

Reduce Your Inflammation

The pain in heel pain comes from inflammation. Along with all the other tips I provide here, you must do something to bring it down. In the office, I could give you a cortisone shot or provide you with MLS laser therapy. But at home there are some things you can do to treat the inflammation yourself.

Ice can also be very beneficial in bringing down the inflammation. Take a water bottle and put it in the freezer. Use is to massage the bottom of your heel while you’re watching television. Use it for 10 minutes and then remove it for 10 minutes and then begin again.

Add Over-the-Counter Shoe Inserts

Finally, adding an over-the-counter insert to the shoe can help prevent your feet from rolling inward or pronating, a problem that can increase your chance of developing heel pain. You might wonder why you’d need to do that with a brand, new pair of expensive tennis shoes. That’s because the insert that’s provided by most shoe companies does not provide sufficient support even if the shoes pass the support test in the video link above.

To demonstrate what I mean, start by taking the insert out of your tennis shoe. When you look inside you’ll notice that it’s totally flat on the bottom of the shoe. Now take the arch support and roll it up from the bottom to the top. If you can easily roll it you’ll understand why it can’t possibly provide the support you need if you have heel pain or you’re prone to it.

The over-the-counter inserts I recommend are Powersteps. These inserts bend at the ball of the foot, not in the middle, and they have a cushioned heel that’s slightly elevated. The combination of these factors can stop you from overpronating relieving stress on your arch. Superfeet are also effective, although Powersteps are little more shock absorbing. Sole Supports are also helpful.

Of course, many people who’ve had heel pain in the past have tried over-the-counter inserts and haven’t gotten much, if any pain relief. If this is true for you, you’ll need to come into the office so I can make you a pair of custom orthotics.

Reduce Your Calf Tightness

The other factor that plays a major role in developing heel pain is tightness of the calf. During two telemedicine appointments, I observed patients walking who also had hard heel strikes and very tight calf muscles. A tight calf doesn’t allow your ankle to bend properly. When that happens the force goes into the foot and adds to the heel pain. It’s imperative to do proper calf stretching to alleviate this problem. Check out our website for more information about how to stretch your calves.

Use A Heel Lift

Finally, a small heel lift can raise your heel just enough to relax the calf muscle temporarily while you’re working to get the inflammation down. I recommend a firm heel lift such as Adjust A Lift. It’s peels apart to provide you with just the right amount of lift. I usually recommend a quarter of an inch. This along with the over-the-counter supports will likely diminish your heel pain.

If these self-care treatments don’t work, please call our office at 206-368-7000 to set up an appointment by telemedicine or in person.

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You've done your best to follow social distancing recommendations. You stick to the six feet rule between you and other people outside of your household. But now that the Centers for Disease Control and Prevention (CDC) is recommending we all wear face masks when out in public, it's been a bit of a scramble to get on board.

Maybe you're lucky and you have someone in your family who's made you a mask. Or perhaps you got one from your neighbor down the street. Regardless there are some important things to know about the right way to make a mask to prevent the spread of Covid-19.

While everyone and their mother out there are touting the best ways to make a mask, I always go to the best source to get my information. And that source is the CDC. Fortunately they've provided guidelines for how to do it yourself in case no one in your immediate vicinity has that capability or the mask you received doesn't meet the following specifications.

Your Mask Must:

Fit snugly and comfortably against the side of your face

Be secured with ties or ear loops

Be made with multiple layers of cotton fabric (tea towels or hand towels you have in your kitchen work well)

Allow for unrestricted breathing

Be able to be washed in the laundry and dried without damage or change to the shape (a shape change could affect how securely it fits to your face)

Warnings: Face masks should never been put on a child under age 2, anyone who already has problems breathing, is unconscious or would not be able to remove the mask without assistance.

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